I watch for research news on breast cancer, treatments, etc., and frequently see interesting articles. There is a topic on BCO called "Breaking Research News from Breastcancer.org." One of the moderators suggested that another topic might be appropriate for posting links and synopses of reports on research found elsewhere. So here it is! Please post links to reports on research form reliable sources. Thanks for sharing!

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

Shetland ...I've been following the MSH6 studies. I had Myriad testing prior to diagnosis (where they told me I had a very low chance of getting breast cancer) and then got diagnosed within months. I have the MSH6 variant which, at the time, was noted as a "variant of unknown significance". The genetic counselor told me to keep checking in because as they collect more data, they tie more genes besides BRCA to breast cancer. And sure enough....

The study reads that a normal woman has a 15% chance of getting breast cancer while a woman with an MSH6 variant has a 30-38% chance of getting breast cancer.

I just don't understand why they can't move faster with this research. It's frustrating.

lala1: regarding the vitamin D levels.... I have done some reading about this because my D levels are sometimes low. My impression is that there seems to still be a good deal of uncertainty around any consequence of vitamin D produced by your body vs vitamin D taken in table/capsule form. I know that they have identified at least one, and quite possibly more, genetic mutations that can be related to vitamin D synthesis. But even people with homozygous (two) mutated genes sometimes do ok so there is obviously more to the story than just the gene pair I have read about. It is possible to be tested but I think that most physicians feel it is not worth it. If you have done a genealogy DNA test, you can run your results thru an analyzer at https://promethease.com/.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

An unhealthy, inflamed gut causes breast cancer to become much more invasive and spread more quickly to other parts of the body, new research from the University of Virginia Cancer Center suggests.

...a research faculty ...found that disrupting the microbiome of mice caused hormone receptor-positive breast cancer to become more aggressive. Altering the microbiome, the collection of microorganisms that live in the gut and elsewhere, had dramatic effects in the body, priming the cancer to spread.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

A class of drugs is emerging that can attack cancer cells in the body without damaging surrounding healthy ones. They have the potential to replace chemotherapy and its disruptive side effects, reshaping the future of cancer care.

The complex biological medicines, called antibody drug conjugates (ADCs), have been in development for decades, and are now generating renewed excitement because of the success of one ADC in late-stage testing, a breast cancer treatment called DS-8201.

"DS-8201 may become one of the largest cancer biologic drugs,''

Analysts say DS-8201 could triple the number of patients who get powerful targeted treatment for breast cancer, the most common tumor in women that kills more than half a million annually. As importantly, its ability to target cancer cells without affecting normal cells is a key advantage over the take-no-prisoners approach of chemotherapy.

Daiichi's treatment has been seen to double survival time for advanced breast cancer patients ... patients using DS-8201 experienced less nausea and hair loss compared with chemotherapy.

DS-8201's full potential is still years away, as it will take time for data to validate the drug's efficacy in a wide range of patients....About 56 pharmaceutical companies are developing ADC candidates..."ADCs are being positioned as a chemo replacement,''

The concept behind ADCs was envisioned in 1900 by German Nobel laureate Paul Ehrlich, who formed the idea of a "magic bullet" in which a single toxic molecule would be delivered to attack a diseased cell without damaging surrounding healthy cells.

The actual use of ADCs began in 2000, but the interest in the sector cooled down as many failed to live up to expectations. The therapies belong to a broader category of cancer immunotherapies that include Merck & Co.'s Keytruda and Novartis AG's CAR T-cell therapy Kymriah that harness the immune system to kill tumors.

Daiichi Sankyo's drug takes ADCs to another level. Its advantage is that it carries eight payloads stably to cancer cells, double the number of the industry standard..."Currently available ADCs are far from being perfect technically because the payload linked to antibodies aren't properly delivered to cancer cells,''... "We wanted to challenge and improve that.

{For HER2 BC}...their first treatment is chemotherapy alongside Roche's Herceptin and Perjeta, a related drug. While DS-8201 is currently in testing for later-stage cancer, the plan is to go up against the first-line treatment *in the next two years.* {emphasis added}

"It would be transformative" if the drug were to become the sole first-line treatment...."If we can eliminate the side effects associated with chemotherapy, that would be a tremendous benefit for women."

"...my gut feeling is that DS-8201 is the most effective among existing medicines targeting HER2 positive patients, including Herceptin and chemotherapy,'' said Shunji Takahashi, deputy director at the Cancer Institute Hospital of the Japanese Foundation for Cancer Research, who took a part in an early-stage DS-8201 trial. He noted that interstitial pneumonia is a concern as a side effect, and needs to be monitored.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

On this: "STUDY: UNHEALTHY GUT PROMOTES SPREAD OF BREAST CANCER" interesting concept and study. It would be more useful if we could define better what really IS a healthy gut and how to get it. Yes, eating a varied, high-fiber, high-vegetation diet and getting plenty of sleep, and having low stress, all probably helps. I think it's hard for many people to grasp that as any prescription for living, achieving a healthy gut, low inflammation, and lower risk of cancer.

Not meaning to shoot the messenger here... Thanks as always for posting these.

See entries regarding The American Gut Project and the British Gut and The Persephone Biome study.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

Regarding Vit D testing--previous MO required, new MO requires it. It's easy to do within the CBC panel labs that I have done before each check up, so (so far) my Vit D is still being monitored. I take Vit D liquid supps (4000 IUs) and when I hike, or walk the dog (nearly every day) I don't use sunblock and try to expose arms and legs for 30 min. My levels are so far above 60, mostly hover around mid 70s. Both MOs wanted levels at 70+, Naturopath wants at least that. MOs get concerned when it rises above 80 since it can skew blood calcium on labs, so 4000 IUs plus exposure seems right to me. At any rate, Vit D testing and supplementing doesn't seem to cause me any harm.

Clinical and Genomic Risk to Guide the Use of Adjuvant Therapy for Breast Cancer

This prospective trial involved 9427 women with HR-positive, HER2-negative, axillary node–negative breast cancer in whom an assay of 21 genes had been performed. Their clinical risk of recurrence of breast cancer was classified as low or high on the basis of the tumor size and histologic grade.

The authors found that clinical-risk stratification provided prognostic information that facilitated the identification of premenopausal women who could benefit from more effective therapy when this prognostic information was combined with the 21-gene recurrence score.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

Great if the Airport Scanners give you a heads up, but don't count on them for diagnostics. An editorial word of caution about those "health scans" provided by some "virtual physical" centers, also. My impression is that they may be pretty good for cardiac issues but they are not very good for cancer detection. Some market themselves as providing early detection of cancer but if you question the providers, they will tell you what most of us know which is that you are not likely to see anything cancerous without contract - which they do no provide. So.... have realistic expectations.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

If you are interested in business start-ups doing cancer research and development, you may be interested in this "blast" that came out from Angel List (angel.co)

Cancer sucks, but there are some exciting developments on the research front. In the last month alone, we've seen regulators consider a CRISPR therapy that directly targets tumor cells—a first for the U.S.—as well as a laser that zaps tumor cells from patients bloodstreams without damaging healthy tissues.

And it's not just the research around new cancer therapies that's exciting. There's a host of startups attempting to tackle other parts of the cancer treatment puzzle, from diagnostics, to emotional support, to medical record logistics.

In the world of diagnostics and early detection, we have startups like:

Freenome, backed by a16z, using unique blood tests and AI to detect early signs of cancer.

Ezra, using full-body MRIs and machine learning to detect 11 kinds of cancer in men and 13 in women.

And then there are other cancer-focused startups that are tougher to categorize, like Belong.life. A platform for cancer patients, it offers a social network where users can connect with other patients, explore a clinical trial matching service, leverage oncologist-staffed support chat, and use a file storage system for medical records.

The number of people diagnosed with cancer makes the potential for impact huge, while the difficulty of the market's core problems makes the barrier to entry for companies high. For a startup looking to innovate and affect as many individuals as possible, there might not be a more exciting space. If you're interested in joining such a startup, search AngelList here.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

Re: DS-8201 and the hope that it will someday replace chemo and its toxic side effects - it's important for people to know that based on Phase I and II trials of DS-8201, the rate of Grade 3 and higher Adverse Events was 50+% (50% for breast cancer, 64% for gastric cancer), 22.9% had a "serious" AE (ie life-threatening, Grade 5 is death), the rate of interstitial lung disease (ILD) has been so high that they now have an independent outside agency monitoring it during the Phase III trials, and the drug was directly responsible for the death of 2 out of the original 12 breast cancer patients in the Phase I trial. Despite those horrific stats, they claim that maximum toxicity was never achieved in Phase I and the drug is "well tolerated". The rate of AEs in Phase II was similar to the rate in Phase I. Other than the ILD, the most common all-grade AEs were "nausea (79.4 percent), decreased appetite (54.1 percent), alopecia (46.5 percent), vomiting (45.9 percent), fatigue (42.4 percent), anemia (40.0 percent), constipation (38.2 percent) and diarrhea (38.2 percent)", so how is this any better than chemo for early stage patients?

Since I'm HER2+ I pay close attention to HER2+ trials and do a lot of research to see what the media doesn't talk about (thank you Vinay Prasad for teaching me how deceptive these media releases for "ground-breaking miracle drugs" can be). With a $7 billion investment riding on this drug I guess it's easy for them to try to convince people that a rate of 50+% Grade 3 and higher AEs is acceptable so they can fast track drug approval, but as someone who is Stage IV and acutely aware of the Quality of Life vs Quantity of Life spectrum and as someone who has already experienced a Grade 3/4 AE that made me wish I was dead, it's not a risk I'd be willing to take in exchange for the possibility of a few extra months of life. It just blows my mind that this is considered an acceptable level of toxicity; I've seen several research oncologists say that a rate of Grade 3 and higher above 10% should be unacceptable and this drug is more than 5x that. It's bad enough that Stage IV patients will be tempted to try something this toxic, but I can't even wrap my mind around the fact that people are talking about possibly using DS-8201 for early stage patients instead of chemo.

I'll be watching the Phase III DESTINY trials closely, but after reviewing the Phase I and Phase II data, I do not share in the excitement about this drug.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

LoriCA, thanks for summarizing and putting in perspective the results from the DS-8201 studies. I also have been following the development of that drug but I hadn't seen the adverse effects numbers that you shared. Do you have a link to the full report on results that you could share? I've had trouble finding anything but the glowing press reports on its efficacy. Thanks!

Margi a lot of the info was shared directly by the drug company itself, Daiichi Sankyo, in their press releases. The media just seems to gloss over it, maybe because it's always near the bottom of the article. The numbers cited in this press release are the updated Phase I results, it mentions the 50% Grade 3 and higher AEs -

So I originally said there were two deaths attributable to the drug and it looks like that number is now 5.

After they released the Phase II trial results I started doing some digging, found the early published Phase I results (not the "updated" results cited above) and some interesting articles posted in other countries that don't have the same marketing spin we often see in the US. Since the first trials including several different types of cancer including breast, gastric, and colorectal, you sometimes have to dig to find the sub-group analyses. Anyway, the links I posted should be a good start for you to get an idea of the safety profile of the drug.

CONCLUSIONS: The prevalence of triple-negative breast cancer among black women in the United States varied significantly by birthplace, particularly among Eastern-African–born black women. These findings underscore the importance of considering geographic origin in studies characterizing breast cancer among women of African descent in the United States and elsewhere.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

A novel approach to cancer immunotherapy injects immune stimulants directly into a tumor to "teach," induce the immune system to destroy the cancer and other tumor cells throughout the body. The three-step approach works as an in-situ cancer vaccine, researchers said.

A preliminary study could point to a new way of making immunotherapy more effective in cancers that have proven to be resistant to treatment and also enhance the effects of checkpoint blockade.

A clinical trial for lymphoma, breast, and head and neck cancer patients opened in March 2019 to test the vaccine with checkpoint blockade. The in-situ vaccine is also being tested in the laboratory in liver and ovarian cancers.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

{This article starts out with a discussion of the TAILORx study which studied avoiding chemotherapy in patients with estrogen receptor (ER)-positive, HER2-negative, lymph node-negative breast cancer. It goes on to discuss a less reported study on the possibility of treating HER2+ BC without chemotherapy.}

A recent study adds another potential method of identifying patients who can benefit from certain treatments, while avoiding chemotherapy. Researchers from Johns Hopkins Kimmel Cancer Center in Baltimore identified a positron emission tomography (PET) scan biomarker that may be able to identify patients with human epidermal growth factor receptor 2 (HER2)–positive breast cancer who might benefit from targeted therapy alone, without chemotherapy.

Study CONCLUSION: Early changes in SULmax predict response to four cycles of PT in estrogen receptor–negative, HER2-positive breast cancer. Once optimized, this quantitative imaging strategy may facilitate a more tailored approach to therapy in this setting.

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right

"We must be willing to let go of the life we have planned, so as to have the life that is waiting for us." "If adventures will not befall a young lady in her own village, she must seek them abroad." "Buy the ticket, take the ride."
Dx
2015, DCIS/IDC, Right, 3cm, Stage IIA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ (IHC)
Targeted Therapy
1/14/2016 Herceptin (trastuzumab)
Chemotherapy
1/14/2016 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
Dx
2017, IDC, Stage IV, metastasized to liver, ER-/PR-, HER2+
Radiation Therapy
Whole-breast: Breast
Surgery
Lumpectomy: Right
Surgery
Lumpectomy: Right